Browse > Article
http://dx.doi.org/10.3340/jkns.2013.53.4.241

Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping  

Byun, Jun Soo (Department of Radiology, Chung-Ang University College of Medicine)
Kim, Jae Kyun (Department of Radiology, Chung-Ang University College of Medicine)
Lee, Hwa Yeon (Department of Radiology, Chung-Ang University College of Medicine)
Hwang, Sung Nam (Department of Neurosurgery, Chung-Ang University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.53, no.4, 2013 , pp. 241-244 More about this Journal
Abstract
The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.
Keywords
Intracranial aneurysm; Endovascular therapy; Stent; Surgical clipping;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hong B, Patel NV, Gounis MJ, DeLeo MJ 3rd, Linfante I, Wojak JC, et al. : Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms. Neurosurgery 65 : 1131-1138; discussion 1138-1139, 2009   DOI
2 Kai Y, Hamada J, Morioka M, Yano S, Mizuno T, Kuratsu J : Double microcatheter technique for endovascular coiling of wide-neck aneurysms using a new guiding device for the transcarotid approach : technical note. Neuroradiology 47 : 73-77, 2005   DOI
3 Lin T, Fox AJ, Drake CG : Regrowth of aneurysm sacs from residual neck following aneurysm clipping. J Neurosurg 70 : 556-560, 1989   DOI
4 Lopes DK, Wells K : Stent remodeling technique for coiling of ruptured wide-neck cerebral aneurysms : case report. Neurosurgery 65 : E1007-E1008; discussion E1008, 2009   DOI
5 Mericle RA, Wakhloo AK, Rodriguez R, Guterman LR, Hopkins LN : Temporary balloon protection as an adjunct to endosaccular coiling of wide-necked cerebral aneurysms : technical note. Neurosurgery 41 : 975-978, 1997   DOI
6 Piotin M, Blanc R, Spelle L, Mounayer C, Piantino R, Schmidt PJ, et al. : Stent-assisted coiling of intracranial aneurysms : clinical and angiographic results in 216 consecutive aneurysms. Stroke 41 : 110-115, 2010   DOI
7 Rabinstein AA, Nichols DA : Endovascular coil embolization of cerebral aneurysm remnants after incomplete surgical obliteration. Stroke 33 : 1809-1815, 2002   DOI
8 Thornton J, Bashir Q, Aletich VA, Debrun GM, Ausman JI, Charbel FT : What percentage of surgically clipped intracranial aneurysms have residual necks? Neurosurgery 46 : 1294-1298; discussion 1298-1300, 2000   DOI
9 Thornton J, Dovey Z, Alazzaz A, Misra M, Aletich VA, Debrun GM, et al. : Surgery following endovascular coiling of intracranial aneurysms. Surg Neurol 54 : 352-360, 2000   DOI
10 Vallee JN, Aymard A, Vicaut E, Reis M, Merland JJ : Endovascular treatment of basilar tip aneurysms with Guglielmi detachable coils : predictors of immediate and long-term results with multivariate analysis 6-year experience. Radiology 226 : 867-879, 2003   DOI
11 Yang PF, Liu JM, Huang QH, Zhao WY, Hong B, Xu Y, et al. : Preliminary experience and short-term follow-up results of treatment of wide-necked or fusiform cerebral aneurysms with a self-expanding, closed-cell, retractable stent. J Clin Neurosci 17 : 837-841, 2010   DOI
12 Bendok BR, Ali MJ, Malisch TW, Russell EJ, Batjer HH : Coiling of cerebral aneurysm remnants after clipping. Neurosurgery 51 : 693-697; discussion 697-698, 2002   DOI
13 Biondi A, Janardhan V, Katz JM, Salvaggio K, Riina HA, Gobin YP : Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms : strategies in stent deployment and midterm follow-up. Neurosurgery 61 : 460-468; discussion 468-469, 2007   DOI
14 de Paula Lucas C, Piotin M, Spelle L, Moret J : Stent-jack technique in stent-assisted coiling of wide-neck aneurysms. Neurosurgery 62 (5 Suppl 2) : ONS414-ONS416; discussion ONS416-ONS417, 2008
15 Debrun GM, Aletich VA, Kehrli P, Misra M, Ausman JI, Charbel F : Selection of cerebral aneurysms for treatment using Guglielmi detachable coils : the preliminary University of Illinois at Chicago experience. Neurosurgery 43 : 1281-1295; discussion 1296-1297, 1998
16 Giannotta SL, Litofsky NS : Reoperative management of intracranial aneurysms. J Neurosurg 83 : 387-393, 1995   DOI
17 Drake CG, Friedman AH, Peerless SJ : Failed aneurysm surgery. Reoperation in 115 cases. J Neurosurg 61 : 848-856, 1984   DOI
18 Drake CG, Vanderlinden RG : The late consequences of incomplete surgical treatment of cerebral aneurysms. J Neurosurg 27 : 226-238, 1967   DOI
19 Feuerberg I, Lindquist C, Lindqvist M, Steiner L : Natural history of postoperative aneurysm rests. J Neurosurg 66 : 30-34, 1987   DOI